Virginia Board of Medicine BOARD BRIEFS · Suzanne N. Everhart, DO Stephen E. Heretick, JD Valerie Hoffman, DC Brent Lambert, MD Juan M. Montero, MD Robert T. Mosby, MD Jane E. Piness,

Department of Health Professions

Virginia Board of Medicine BOARD BRIEFS

Board Members

Thomas B. Leecost, DPM President Malcolm L. Cothran, MD Vice-President

Gopinath Jadhav, MD Secretary/Treasurer Gen. Clara Adams-Ender, RN John H. Armstrong, MD

Sandra A. Bell, MD Christine O. Bridge Patrick W. Clougherty, MD

Carol E. Comstock, RN Claudette Dalton, MD Suzanne N. Everhart, DO Stephen E. Heretick, JD

Valerie Hoffman, DC Brent Lambert, MD Juan M. Montero, MD Robert T. Mosby, MD

Jane E. Piness, MD Karen A. Ransone, MD

Board Staff

William L. Harp, MD Executive Director

Barbara Matusiak, MD Medical Review Coordinator Kate Nosbisch Practitioner Information

Deputy Executive Director Karen Perrine, Discipline Deputy Executive Director Ola Powers, Licensing

Deputy Executive Director Colanthia Morton Opher Operations Manager

Newsletter #67 December 2005

Liability Protection for Provision of Health Care Services to Patients of Free Clinics

P ursuant to Virginia Code §54.1-106, any licensee who renders at any site any health care services within the limits of his or her scope of practice, voluntarily and without compensation, to any patient of any clinic that is organized in whole or in part for the delivery of health care services without charge, shall not be liable for any civil damages for any act or omission resulting from the rendering of such services unless the act or omission was the result of his or her gross negligence or willful mis-conduct. Any person rendering such health care services who (i) is registered with the Division of Risk Management and (ii) has no legal or financial interest in the clinic from which the patient is referred shall be deemed an agent or the Commonwealth and to be act-ing in an authorized governmental capacity with respect to delivery of such health care services. The premium for coverage of such person under the Risk Management Plan shall be paid by the Department of Health. This coverage is available even if the free clinic is not covered by a Division of Risk Management plan and even if the services rendered are provided at a location other than the free clinic itself. To be covered, a practitioner should contact the Division of Risk Management, logging on to the Vir-ginia Department of Treasury’s website at www.trs.virginia.gov and clicking the link to Risk Management. Alternatively, you may contact the Division of Risk Management by mail at P. O. Box 1879, Richmond, Virginia 23218-1879.

New Format For Prescription Blanks Required July 1, 2006

A law from the 2003 Session of the General Assembly will affect your practice next year. The prescription format (in use since 1993) that requires two check boxes, one for Dispense as Written and the other for Voluntary Formulary Permitted, will not meet the requirements of the law after June 30, 2006. Many of you are still using this format, and have been permitted to do so by law. However, by July 1, 2006, your prescription blank will have to conform to the requirements of the 2003 law. The law allows a pharmacist to dispense a therapeutically equivalent drug for a brand-name drug unless the prescriber indicates that such a substitution should not take place. THIS MUST BE DONE BY SPECIFCYING “BRAND MEDICALLY NECES-SARY” ON THE PRESCRIPTION. This may be written out longhand in a space provided on the blank. Alternatively, you may wish to have BRAND MEDICALLY NECESSARY pre-printed on your prescription blanks, with a check box or language that says “if circled”…. Just be sure the format you choose can be clearly understood by the pharmacist.

Page 1 Newsletter #67

Virginia Board of Medicine 2 Newsletter #67

N EW LAWS Consolidation of Unprofessional Conduct Laws The Board’s law regarding unprofessional conduct is now found in Virginia Code Sec-tion § 54.1-2915 and clearly applies to indi-viduals who are applying for licenses to prac-tice in Virginia. Certified Professional Midwives The Board of Medicine now licenses certified professional midwives. Midwifery is defined as “primary maternity care that is consistent with a midwife’s training, education, and ex-perience to women and their newborns throughout the childbearing cycle, and identi-fying and referring women or their newborns who require medical care to an appropriate practitioner.” Licensure will require certifica-tion with the North American Registry of Midwives. Emergency regulations are being developed. Referral to Family Members Virginia’s Practitioner Self-Referral Act now permits referrals to members of your immedi-ate family or your immediate family member’s office or group practice, provided certain con-ditions are met, including that the practitioner to whom the referral is made is licensed and qualified and the referral is in the best interest of the patient. Federal laws and regulations must be followed as well. Psychotherapy Notes Now Protected Psychotherapy notes are understood to be “comments, recorded in any medium by a health care provider who is a mental health professional, documenting or analyzing the contents of conversation during a private counseling session with an individual or a

group, joint, or family counseling session that are separated from the rest of the individual’s health record.” They are to be released only by an individual’s written authorization except within training programs, in defense of the treatment rendered, to protect third parties from physical harm, in the course of an inves-tigation, audit or review or as otherwise re-quired by law. Release of Medical Information Minors who consented to their own treatment are now included as individuals that can au-thorize release of protected health informa-tion. Enhanced Prescription Monitoring Program The Prescription Monitoring Program has in-cluded about 25% of Virginia pharmacies, chiefly in the Southwest, and has only tracked Schedule II drugs. It is being expanded to the entire state and will include Schedules II-IV. Of great utility to prescribers will be the ability to obtain information on a patient’s prescrip-tion history to assist the practitioner in deter-mining whether a prescription should be is-sued to the patient. Doctors using the PMP in this manner must have written consent from the patient. Prescribers who wish to utilize the system should log onto www.dhp.virginia.gov and download the request form from “Services for Practitioners.” You Must Inform Your Patients Should a patient ask how to access the infor-mation in your Board of Medicine profile, you must inform them how to do so. Should a patient not be covered by an insurance plan you accept or a managed care insurance plan with which you participate, you must inform the patient that he/she may be responsible for


the total charges for services. Charges for Medical Records There is new law on what you may charge pa-tients for records. You “may impose a rea-sonable cost-based fee, which shall include only the cost of supplies for and labor of copying the requested information, postage when the individual requests that such infor-mation be mailed, and preparation of an ex-planation or summary of such information as agreed to by the individual.” Compounding of Drugs for Administra-tion in Physicians’ Practices The mixing, diluting and reconstituting of drugs for administration in the office has been carved out of pharmacy law and will be sub-ject to Board of Medicine regulations. An ad hoc committee has been working on these regulations, which are emergency regulations and must be in place by year’s end. They will be sent to you in the next newsletter and will be placed on the board’s website when they become effective. Athletic Trainers Athletic trainers can now possess and admin-ister Schedule VI topical drugs routinely used in their practice, and can also possess and ad-minister epinephrine for anaphylactic shock. Also, athletic trainers lawfully licensed in an-other jurisdiction may accompany their teams/athletes into Virginia and engage in practice for the duration of the scheduled event. Witnesses to an Advanced Directive Any person over 18, including a spouse or blood relative, can now witness an advanced directive.

Pilot Programs for Obstetrics and Pediatrics The Board of Health is authorized to approve pilot programs for obstetrical care of low-risk pregnancy by nurse midwives in underserved areas. Protocols are to be established in sup-port of this program by stakeholder healthcare providers utilizing nationally accepted criteria for risk assessment, referral and backup. The program is not intended for home births. Physician Competency Evaluations Beginning July 1, 2005, any licensee of the Board of Medicine that accrues his/her third paid claim for malpractice will be required to undergo a competency evaluation. The Board is in the process of determining the imple-mentation of this statute. Immunity for Voluntary Reporting Any person making a voluntary report to the appropriate regulatory board or to the Depart-ment of Health Professions regarding the un-professional conduct or competency of any practitioner licensed, certified, or registered by a health regulatory board shall be immune from any civil liability resulting from the re-port unless it was made in bad faith or with malicious intent. Persons required to make such reports already have this immunity. Physician Assistants in the Emergency Department Physician assistants may practice in an emer-gency department under the continuous su-pervision of their physician supervisor, who need not be in the facility. The supervising physician must be available to both the PA and the ED physician for consultation. Dis-charge plans must be communicated to the supervisor and the ED physician prior to the patient’s discharge.


N EW REGULATIONS Below are new ethics regulations that became effective October 19, 2005. Only those appli-cable to MDs, DOs, DPMs and DCs are printed. The ethics regulations for all the other professions are very similar, and are available on the Board’s website at http://www.dhp.virginia.gov/medicine. Part II. Standards of Professional Conduct .

18VAC85-20-25. Treating and prescribing for self or family. A. Treating or prescribing shall be based on a bona fide practitioner-patient relationship, and prescribing shall meet the criteria set forth in § 54.1-3303 of the Code of Virginia. B. A practitioner shall not prescribe a con-trolled substance to himself or a family mem-ber, other than Schedule VI as defined in § 54.1-3455 of the Code of Virginia, unless the prescribing occurs in an emergency situation or in isolated settings where there is no other qualified practitioner available to the patient, or it is for a single episode of an acute illness through one prescribed course of medication. C. When treating or prescribing for self or family, the practitioner shall maintain a patient record documenting compliance with statu-tory criteria for a bona fide practitioner-patient relationship. 18VAC85-20-26. Patient records. A. Practitioners shall comply with provisions of § 32.1-127.1:03 of the Code of Virginia re-lated to the confidentiality and disclosure of patient records. B. Practitioners shall provide patient records to another practitioner or to the patient or his personal representative in a timely manner in accordance with provisions of § 32.1-127.1:03

of the Code of Virginia. C. Practitioners shall properly manage patient records and shall maintain timely, accurate, legible and complete patient records. D. Practitioners shall maintain a patient re-cord for a minimum of six years following the last patient encounter with the following ex-ceptions: 1. Records of a minor child, including immu-nizations, shall be maintained until the child reaches the age of 18 or becomes emanci-pated, with a minimum time for record reten-tion of six years from the last patient encoun-ter regardless of the age of the child; or 2. Records that have previously been trans-ferred to another practitioner or health care provider or provided to the patient or his per-sonal representative; or 3. Records that are required by contractual obligation or federal law [may need] to be maintained for a longer period of time. E. From October 19, 2005, practitioners shall post information or in some manner inform all patients concerning the time frame for re-cord retention and destruction. Patient re-cords shall only be destroyed in a manner that protects patient confidentiality, such as by in-cineration or shredding. F. When a practitioner is closing, selling or relocating his practice, he shall meet the re-quirements of § 54.1-2405 of the Code of Virginia for giving notice that copies of re-cords can be sent to any like-regulated pro-vider of the patient's choice or provided to the patient.

18VAC85-20-27. Confidentiality. A practitioner shall not willfully or negligently breach the confidentiality between a practitio-


ner and a patient. A breach of confidentiality that is required or permitted by applicable law or beyond the control of the practitioner shall not be considered negligent or willful. 18VAC85-20-28. Practitioner-patient com-munication; termination of relationship. A. Communication with patients. 1. Except as provided in § 32.1-127.1:03 F of the Code of Virginia, a practitioner shall accu-rately inform a patient or his legally authorized representative of his medical diagnoses, prog-nosis and prescribed treatment or plan of care. A practitioner shall not deliberately make a false or misleading statement regarding the practitioner’s skill or the efficacy or value of a medication, treatment, or procedure pre-scribed or directed by the practitioner in the treatment of any disease or condition. 2. A practitioner shall present information relating to the patient’s care to a patient or his legally authorized representative in under-standable terms and encourage participation in the decisions regarding the patient’s care. 3. Before surgery or any invasive procedure is performed, informed consent shall be ob-tained from the patient in accordance with the policies of the health care entity. Practitioners shall inform patients of the risks, benefits, and alternatives of the recommended surgery or invasive procedure that a reasonably prudent practitioner in similar practice in Virginia would tell a patient. a. In the instance of a minor or a patient who is incapable of making an informed decision on his own behalf or is incapable of commu-nicating such a decision due to a physical or mental disorder, the legally authorized person available to give consent shall be informed and the consent documented. b. An exception to the requirement for con-

sent prior to performance of surgery or an invasive procedure may be made in an emer-gency situation when a delay in obtaining con-sent would likely result in imminent harm to the patient. c. For the purposes of this provision, “invasive procedure” shall mean any diagnos-tic or therapeutic procedure performed on a patient that is not part of routine, general care and for which the usual practice within the health care entity is to document specific in-formed consent from the patient or surrogate decision-maker prior to proceeding. 4. Practitioners shall adhere to requirements of § 32.1-162.18 of the Code of Virginia for obtaining informed consent from patients prior to involving them as subjects in human research, with the exception of retrospective chart reviews. B. Termination of the practitioner/patient relationship. 1. The practitioner or the patient may termi-nate the relationship. In either case, the prac-titioner shall make a copy of the patient re-cord available, except in situations where de-nial of access is allowed by law. 2. Except as provided in § 54.1-2962.2 of the Code of Virginia, a practitioner shall not ter-minate the relationship or make his services unavailable without documented notice to the patient that allows for a reasonable time to obtain the services of another practitioner. 18VAC85-20-29. Practitioner responsibility. A. A practitioner shall not: 1. Knowingly allow subordinates to jeopardize patient safety or provide patient care outside of the subordinate’s scope of practice or area of responsibility. Practitioners shall delegate patient care only to subordinates who are


properly trained and supervised; 2. Engage in an egregious pattern of disrup-tive behavior or interaction in a health care setting that interferes with patient care or could reasonably be expected to adversely im-pact the quality of care rendered to a patient; 3. Exploit the practitioner/patient relationship for personal gain. B. Advocating for patient safety or improve-ment in patient care within a health care entity shall not constitute disruptive behavior pro-vided the practitioner does not engage in be-havior prohibited in A 2 of this section. 18VAC85-20-30. Advertising ethics. A. Any statement specifying a fee, whether standard, discounted or free, for professional services which does not include the cost of all related procedures, services and products which, to a substantial likelihood, will be nec-essary for the completion of the advertised service as it would be understood by an ordi-narily prudent person shall be deemed to be deceptive or misleading, or both. Where rea-sonable disclosure of all relevant variables and considerations is made, a statement of a range of prices for specifically described services shall not be deemed to be deceptive or mis-leading. B. Advertising a discounted or free service, examination, or treatment and charging for any additional service, examination, or treat-ment which is performed as a result of and within 72 hours of the initial office visit in re-sponse to such advertisement is unprofes-sional conduct unless such professional ser-vices rendered are as a result of a bona fide emergency. This provision may not be waived by agreement of the patient and the practitio-ner. C. Advertisements of discounts shall disclose

the full fee that has been discounted. The practitioner shall maintain documented evi-dence to substantiate the discounted fees and shall make such information available to a consumer upon request. D. A licensee shall disclose the complete name of the specialty board which conferred the certification when using or authorizing the use of the term “board certified” or any simi-lar words or phrase calculated to convey the same meaning in any advertising for his prac-tice. E. A licensee of the board shall not advertise information which is false, misleading, or de-ceptive. For an advertisement for a single practitioner, it shall be presumed that the practitioner is responsible and accountable for the validity and truthfulness of its content. For an advertisement for a practice in which there is more than one practitioner, the name of the practitioner or practitioners responsible and accountable for the content of the adver-tisement shall be documented and maintained by the practice for at least two years. 18VAC85-20-40. Vitamins, minerals and food supplements. A. The recommendation or direction for the use of vitamins, minerals or food supplements and the rationale for that recommendation shall be documented by the practitioner. The recommendation or direction shall be based upon a reasonable expectation that such use will result in a favorable patient outcome, in-cluding preventive practices, and that a greater benefit will be achieved than that which can be expected without such use. B. Vitamins, minerals, or food supplements, or a combination of the three, shall not be sold, dispensed, recommended, prescribed, or suggested in doses that would be contraindi-cated based on the individual patient’s overall


medical condition and medications. C. The practitioner shall conform to the stan-dards of his particular branch of the healing arts in the therapeutic application of vitamins, minerals or food supplement therapy. 18VAC85-20-50. Anabolic steroids. A practitioner shall not sell, prescribe, or ad-minister anabolic steroids to any patient for other than accepted therapeutic purposes. 18VAC85-20-60 to 18VAC85-20-70. [Repealed]

18VAC85-20-80. Solicitation or remunera-tion in exchange for referral. A practitioner shall not knowingly and will-fully solicit or receive any remuneration, di-rectly or indirectly, in return for referring an individual to a facility or institution as defined in §37.1-179 of the Code of Virginia, or hospi-tal as defined in §32.1-123 of the Code of Vir-ginia. Remuneration shall be defined as compensa-tion, received in cash or in kind, but shall not include any payments, business arrangements, or payment practices allowed by Title 42, §1320a-7b(b) of the United States Code, as amended, or any regulations promulgated thereto. 18VAC85-20-90. Pharmacotherapy for weight loss. A. A practitioner shall not prescribe ampheta-mine, Schedule II, for the purpose of weight reduction or control. B. A practitioner shall not prescribe con-trolled substances, Schedules III through VI, for the purpose of weight reduction or control in the treatment of obesity, unless the follow-ing conditions are met:

1. An appropriate history and physical exami-nation are performed and recorded at the time of initiation of pharmacotherapy for obesity by the prescribing physician, and the physician reviews the results of laboratory work, as indi-cated, including testing for thyroid function; 2. If the drug to be prescribed could ad-versely affect cardiac function, the physician shall review the results of an electrocardio-gram performed and interpreted within 90 days of initial prescribing for treatment of obesity; 3. A diet and exercise program for weight loss is prescribed and recorded; 4. The patient is seen within the first 30 days following initiation of pharmacotherapy for weight loss, by the prescribing physician or a licensed practitioner with prescriptive author-ity working under the supervision of the pre-scribing physician, at which time a recording shall be made of blood pressure, pulse, and any other tests as may be necessary for moni-toring potential adverse effects of drug ther-apy; 5. The treating physician shall direct the fol-low-up care, including the intervals for patient visits and the continuation of or any subse-quent changes in pharmacotherapy. Con-tinuation of prescribing for treatment of obe-sity shall occur only if the patient has contin-ued progress toward achieving or maintaining a target weight and has no significant adverse effects from the prescribed program. 18VAC85-20-100. Sexual contact. A. For purposes of § 54.1-2915 A 12 and A 19 of the Code of Virginia and this section, sex-ual contact includes, but is not limited to, sex-ual behavior or verbal or physical behavior which: 1. May reasonably be interpreted as intended


for the sexual arousal or gratification of the practitioner, the patient, or both; or 2. May reasonably be interpreted as romantic involvement with a patient regardless of whether such involvement occurs in the pro-fessional setting or outside of it. B. Sexual contact with a patient. 1. The determination of when a person is a patient for purposes of § 54.1-2915 A 19 of the Code of Virginia is made on a case-by-case basis with consideration given to the nature, extent, and context of the professional rela-tionship between the practitioner and the per-son. The fact that a person is not actively re-ceiving treatment or professional services from a practitioner is not determinative of this issue. A person is presumed to remain a pa-tient until the patient-practitioner relationship is terminated. 2. The consent to, initiation of, or participa-tion in sexual behavior or involvement with a practitioner by a patient does not change the nature of the conduct nor negate the statutory prohibition. C. Sexual contact between a practitioner and a former patient. Sexual contact between a practitioner and a former patient after termination of the practi-tioner-patient relationship may still constitute unprofessional conduct if the sexual contact is a result of the exploitation of trust, knowl-edge, or influence of emotions derived from the professional relationship. D. Sexual contact between a practitioner and a key third party shall constitute unprofessional conduct if the sexual contact is a result of the exploitation of trust, knowledge or influence derived from the professional relationship or if the contact has had or is likely to have an adverse effect on patient care. For purposes of

this section, key third party of a patient shall mean: spouse or partner, parent or child, guardian, or legal representative of the patient. E. Sexual contact between a medical supervi-sor and a medical trainee shall constitute un-professional conduct if the sexual contact is a result of the exploitation of trust, knowledge or influence derived from the professional relationship or if the contact has had or is likely to have an adverse effect on patient care.

18VAC85-20-105. Refusal to provide infor-mation. A practitioner shall not willfully refuse to pro-vide information or records as requested or required by the board or its representative pursuant to an investigation or to the enforce-ment of a statute or regulation.

R egulatory Actions Underway

MDs and DOs will soon be subject to new regulations governing the mixing, diluting or reconstituting of drugs in their practices. The regulations are a requirement of law passed in the 2005 Session of the General Assembly. Essentially, there will be certain guidelines to follow whenever two or more sterile products are mixed together to prepare a medication for administration. The regulations are currently under review by the Executive Branch. When they become final, they will be presented in a special edition Board Briefs. MDs, DOs, and DPMs are currently re-quired to report certain adverse information on their profiles, including malpractice paid claims. All adverse information is required to be reported on one’s profile within 30 days of occurrence. In the instance of a paid claim, that is 30 days from the date the claim is paid. Also, clarification of what is considered a paid claim is under discussion. The conclusion from that discussion will be memorialized in Board of Medicine regulation. Until that regu-


lation is available, feel free to call the Board’s Call Center for information on what is re-quired to be reported. The number is (804) 662-9999. Regulations are being prepared to clearly indi-cate that physicians who are not anesthesiolo-gists, but are trained and competent to per-form major conductive blocks, may perform such procedures in their practices. The re-quest for rule-making in this matter came from the Virginia Society of Physical Medicine and Rehabilitation. Respiratory therapists petitioned that rele-vant AMA-approved Category I courses be considered Type I Continuing Education in addition to those courses approved by the American Association for Respiratory Care. This regulation has been approved by the Ex-ecutive Branch will be effective January 11, 2006, such that such sources can be claimed by respiratory therapists at the time of their 2007 license renewal.

R adiology Technology Continuing Education Audit

All radiology technologists and radiology tech-nology-limiteds that renewed in 2005 had to attest to having attained 24 hours of continu-ing education in the two years prior to re-newal. At least 12 of the hours must meet the criteria for Category A continuing education as delineated by the American Registry of Ra-diologic Technology. The Advisory Board recommended and the Board of Medicine ap-proved a 10% audit of continuing education from the 2005 renewals. Accordingly, about 250 licensees will receive letters asking for the submission of documentation for their con-tinuing education. Should you receive one of these letters, be sure you respond promptly.

P hysician Assistant Supervision All MDs, DOs and DPMs that supervise phy-

sician assistants should be familiar with their supervisory responsibilities. A supervising physician may only supervise two Physician Assistants (PAs) at any one time. The super-vision must be continuous, but that does not necessarily mean being present in person. The supervisor must develop a protocol with the PA that identifies the PA’s scope of practice, delegation of medical tasks, parameters for communication and consultation, and an evaluation process to judge the PAs perform-ance. A supervisor may only delegate to and supervise a PA in medical areas/procedures in which the supervisor is proficient. A supervi-sor may authorize a PA to initially evaluate patients in outpatient, inpatient and emer-gency department settings as long as it is done under the direction, supervision and control of the supervising physician. The supervisor must instruct the PA to contact him/her as soon as possible for acute conditions or changes that would warrant communication with the supervisor. The supervisor must in-struct the PA that any patient seen in the emergency department setting with a life-threatening condition be immediately trans-ferred to the supervising physician. Addition-ally, the care given by a PA in an emergency department must be reviewed by the supervi-sor prior to the patient’s discharge. The PA also has the responsibility of informing the emergency department physician of the pro-posed treatment/disposition plan. The super-vising physician must be available at all times that he/she is authorizing a PA to see patients for him/her in the emergency department. The supervising physician must see and evalu-ate any patient who presents with the same complaint twice in a single episode of care and has failed to improve significantly. For con-tinuing illnesses, the supervising physician must see the patient at least every fourth visit. And as with the emergency department, the PA must alert the supervisor to acute or sig-nificant findings with a patient. The supervis-ing physician is responsible for all invasive procedures. Procedures that the PA may do


under general supervision without Board ap-proval are insertion of an NG tube, bladder catheter, needle, peripheral IV catheter and may perform minor suturing, venipuncture and SC, IM and IV injections. Any procedure not listed here is considered invasive and must be done under direct supervision. After a PA performs a particular invasive procedure three or more times, and is considered by the super-vising physician to be competent to perform it under general supervision, a request can be made of the Board for this authority. The su-pervising physician is responsible for all pre-scriptions issued by the PA, both drugs and devices. Supervisors should remain mindful that in his/her absence, an alternate supervi-sor must be designated for the PA. A proto-col between the PA and the alternate supervi-sor should be in place. PAs have the authority to prescribe schedules III-VI controlled drugs and must have the approval of the board and hold a current DEA certificate to do so.

C ompetency Evaluations and Three Paid Claims The 2005 Session of the General Assembly enacted law requiring any licensee of the Board of Medicine who accrues three paid claims in a ten-year period to undergo a com-petency evaluation. This law became effective July 1, 2005. Therefore, any licensee who ac-crues his/her third (or greater) paid claim on or after that date will be subject to this law. The Board is in the process of developing guidelines for the implementation of the com-petency evaluations.

D EA Requirements for Prescribing Schedule II Drugs Clarification of the DEA’s Interim Policy Statement on this issue was printed in the Au-gust 26, 2005 issue of the Federal Register. The Federal Register reiterates the fact that

preparing multiple prescriptions for a Sched-ule II drug on the same day with instructions to fill them on different days is tantamount to refills, which is prohibited by the federal Con-trol Substances Act. There is no federal or state law or regulation limiting a prescription for a Schedule II controlled substance to a 30 day supply. However, it is required that each time a prescription is written, the physician properly determine that there is a legitimate medical purpose for the patient to get the medicine. The clarification of the Interim Policy Statement specifies that physicians are to utilize “the utmost care” in determining whether a particular patient needs to be seen each time a prescription is issued or whether seeing the individual at less frequent intervals is consistent with sound medical practice. Prescriptions for Schedule II controlled sub-stances may be mailed to a patient’s pharmacy. A prescription may be faxed, but the original written, signed prescription must be in the pharmacist’s hands prior to dispensing of the drug.

D EA Allows Digital Signature for Or-dering Schedule I and II Drugs

DEA law and regulations have required the use of preprinted, serialized DEA Form 222 for the ordering of Schedule I and II sub-stances. Suppliers of these drugs are required to have a paper order form in hand before filling the order. Both the supplier and the purchases must keep a copy of the executed order form for 2 years. As of April 1, 2005, with the publication of the Final Rule in the Federal Register, a purchaser will be permitted to use a digital signature to order Schedules I and II. DEA will operate the Certification Authority to issue a digital certificate to a per-son who is authorized to order Schedule I and II drugs. If you need further information on this matter, please call the DEA Liaison and Policy Section at (202) 307-7297. This policy is consistent with the Virginia Drug Control Act.


M edicare Part D Prescription Drug Benefit In 2006, Medicare beneficiaries will be able to enroll in Medicare Part D-the Voluntary Pre-scription Drug Benefit Program. To enroll, an individual must be entitled to or be enrolled in Medicare Parts A and B. The Part D benefit will be provided through private prescription drug plans (drugs only) or through Medicare Advantage programs that are essentially HMO’s with the drug benefit integrated into

the plan. Part D will help those with limited means, offer a choice of at least two drug plans, offer convenient access to pharmacies, guarantee that Medicare beneficiaries living in nursing facilities will be able to enroll in a drug plan and that beneficiaries who have both full Medicare and Medicaid benefits are automati-cally enrolled in a drug plan. The premium for Part D is expected to be approximately $35 a month. Some beneficiaries may qualify for a low-income subsidy.

The Board of Medicine Welcomes a New Advisory Board

T he Virginia Board of Medicine officially welcomed the newly appointed members of the Advisory Board on Midwifery in June 2005. At the first meeting the members voted to appoint Leslie Payne, CPM, as Chair and Peggy Franklin, CPM the Vice-Chair. The other members are: Deren Bader, CPM, DrPH, Wade Nieman, MD and Sheryl Rivett, citizen member

Board Member Update

T he following new appointments were made July 1, 2005. General Clara L. Adams-Ender succeeded Alvin Edwards, Claudette Dalton, MD succeeded Gary Miller, MD, Valerie L. Hoff-man, DC succeeded Jerry Willis, DC, and Brent Lambert, MD succeeded Thomas Hulvey, MD. At a special called meeting on September 16, 2005, the board members unanimously elected Tho-mas Leecost, DPM as Board Chair, Malcolm Cothran, Jr., MD as Vice-Chair, and Gopinath Jadhav, MD as Secretary-Treasurer.

Athletic Trainers

A thletic Trainers have been added to the list of identified professions required to provide Emergency Contact Information. You should have recently received a letter informing you of this requirement at you address of record. If you did not receive the letter, please contact the Practitio-ner Information Division at [email protected] to confirm/update your address of record and request a copy of the letter. The collection of this information is required by law and is for the sole purpose of rapid dissemination of information in the event of a public health emergency. THIS INFORMATION IS NOT RELEASABLE TO THE PUBLIC.


License

Maintenance

L icense renewal notices are placed in the mail approximately 45 days prior to the expiration date of the license to practice. Beginning in December of this year, renewals for the following professions will be mailed and are to be re-newed no later than the last day of your birth month if you wish to continue to practice. Those professions with mandatory continuing education will also need to meet that requirement in order to renew.

• Medicine and Surgery

• Osteopathic Medicine

• Chiropractic

• Podiatry

• Occupational Therapy

Annual renewals for Intern Residents will also be mailed out in early April 2006.

K eeping information updated relating to your professional license to practice is as easy as 1-2-3. To remain compliant with the law and to ensure that you are receiving correspon-dence from the Board regarding new laws and regulations, and reminders for license re-newal, the following three rules must be observed:

1. Keep your address of record current with the Board. All address changes are required to come to the Board in writing as a protection to the practitioner. This information may be:

• emailed from an address that can be easily identified as the licensee’s; • faxed; • mailed through the postal service; • or simply updated on your Profile (which will automatically notify the Board).

Once your address has been changed, you will receive a letter acknowledging the update for your files. If you require a pocket license with the updated address, the request must come in to the Board office with a $5.00 check or money order payable to the “Treasurer of Virginia”. 2. Update your on-line Virginia Profile within thirty days of any change. If you require assistance accessing your Profile or need your password, you can contact the Call Center at 804-662-9999. 3. Last, but not least, maintain your continuing medical education hours. The forms for tracking this information may be located on our website at http://www.dhp.virginia.gov/medicine/medicine_forms.htm#CME

2006

Renewal

Reminders


2 005 Random Audit The Virginia Board of Medicine is preparing a random au-dit on 2% of the completed Practitioner Profiles of MD, DO, DPM, Intern and Resident and University Limited Licenses. All information on your profile is to be up-dated within 30 days of a change, in accordance with Board regulations. Even if you have no changes to your informa-tion, a section of the profile that requires updating annually is the Years in Active/Clinical Practice if you are a prac-ticing doctor. If you hold a MD, DO, DPM, Intern and Resident or Uni-versity Limited License, you can update your profile at www.vahealthprovider.com/edit by entering your license number and password. If you have forgotten your pass-word, contact [email protected] or 804-662-9999 and your password will be sent to your address of record or to a previously established non-emergency email address. If you are selected for the audit and the Board finds every-thing to be accurate and complete, you should receive a letter in December 2005 informing you that you were se-lected for the random audit, thanking you for complying, and reminding you to make any future changes within 30 days of the change. If you are selected for the audit, and information is found to be missing or inaccurate, you may be contacted by the Board via Courtesy Letter, Confidential Consent Agree-ment, or a Notice to appear before the Board depending on the nature of the missing/inaccurate information. Profile Completion Statistics As of October 31, 2005, 99% of all current active/inactive MDs, DOs, and DPMs, Intern and Residents, and Univer-sity Limited licensees have completed their profiles. Haven't completed your profile yet? To complete your profile visit www.vahealthprovider.com/edit and enter your license number and password. If you have fo rgo t t en you r pa s sword , con t ac t [email protected] or 804-662-9999 and your password will be sent to your address of record.

If you hold more than one license (ex: MD and Intern/Resident or DO and Intern/Resident) you are required to complete a profile for each license. If you only hold an Intern/Resident license, you are required to complete a profile. How does your profile look to the public? Visit www.vahealthprovider.com, click on the search icon, type in your last name in the indicated box and then click on your name from the listing. What is new on the profiling website?

2004

1. The American Board of Multiple Specialties in Podia-

try was added to recognized board certifications. 2. Since December 2004, patients can now search for a

doctor by languages spoken in the office.

2005

1. Bon Secours St. Francis Medical Center added to as a selection to VA Hospital affiliations.

2. Medical Informatics has been added to the list of self- designated specialties. 3. The post-graduate school/names have been updated. 4. Telephone interpretation is now available under the

non-English languages spoken in practice locations. If you offer this service, and select telephone interpreta-tion as a non-English language spoken in your office on your profile, your name will show up whenever an individual does an advanced search for any specific non-English language spoken at a practice location.

Things to Remember 1. Regulations require you to keep your address of record

and profile updated within 30 days of change. 2. Providing a non-emergency email address to the Board

allows us to send your password to you electronically and provides us with a faster, more efficient way to communicate with you.

- Kate Nosbisch

Deputy Executive Director

Practitioner Information Section


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O nline Workforce Survey As with the 2004 online renewals, an optional workforce survey is available to those renewing online in 2006. The information gleaned will be used by Virginia’s schools of medicine to describe the current medical workforce and to project needs for the future. The survey is voluntary. Please take the time to participate in this worthy project.

R evisions to Board of Pharmacy regulations regarding schedule VI drugs and devices Revisions to regulations of the Board of Pharmacy will go into effect on January 11, 2006 regarding schedule VI drugs and devices. The revisions to 18 VAC 110-20-320 B read: A prescription for Schedule VI drug or device shall not be dispensed or refilled more than one year after the date on which it was issued, unless the prescriber specifically authorizes dispensing or refilling for a longer period of time not to exceed two years. Previously, the regulation authorized dispensing or refilling for two years absent any specification.

Board Meeting Dates

Full Board Meetings February 23-25

June 22-24 October 19-21

Executive Committee

April 7 August 11 December 8

Legislative Committee

January 27 May 19 September 22

Advisory Boards

Occupational Therapy and Respiratory Care: February 7, June 6, October 3 Acupuncture and Radiological Technology: February 8, June 7, October 4 Athletic Training and Physician Assistant: February 9, June 8, October 5 Midwifery: February, 10, June 9, October 6

Information on times and board rooms can be accessed on http://www.dhp.virginia.gov/medicine/medicine_calendar.htm

2006


BOARD DECISIONS You may access these decisions at www.dhp.virginia.gov (select “On Line License Lookup”) or at www.vahealthprovider.com for most MD’s, DO’s and DPM’s. You may also contact the Board Office at (804) 662-7693 to request a copy.

August 10, 2004 to December 31, 2004, unless otherwise noted. NAME AND LICENSE NO. DATE

OF ACTION

ACTION

Alberts, Wayne W., MD – 0101-032684 Falls Church, VA

10/15/04 Permanent surrender for suspension of the privilege to renew license based on engaging in conduct and contact of an inappropriate nature with a patient.

Ambrose, Heather S., MD – 0101-225801 Greenville, NC

12/02/04 Compliance obtained, effective 12/2/04, with Board’s Order of 12/10/03.

Baltierra, Maria D., MD – 0101-049113 Burbank, CA

10/22/04 Reinstatement granted; license issued on terms.

Beargie, Richard J., MD – 0101-027284 Middleburg, VA

11/04/04 Indefinite probation based on negligence and surgical error in a single case.

Blevins, Douglas D., MD – 0101-032498 Durham, NC

07/26/04 Reinstatement granted; license issued on probation with terms.

Boone, Lewis B., MD – 0101-022443 Ettrick, VA

07/16/04 Reinstatement denied based on failure to establish competency to safely resume practice of medicine.

Clarke Jr., William E., MD – 0101-021477 Roanoke, VA

08/11/04 Monetary penalty of $1500 imposed for failure to provide Practitioner Profile information to the Board.

Crosby, Charles J., DO – 0102-036881 Orlando, FL

10/21/04 Mandatory suspension based on suspension of license by State of Florida Department of Health.

Cunningham, Dean S., MD – 0101-040012 Manassas, VA

10/15/04 Permanent surrender of right to seek reinstatement of license based on a felony conviction for health care fraud.

DeForge, Susan Young, RCP – 0117-002264 Palmyra, VA

10/18/04 Surrender for suspension based on inability to practice with reasonable skill & safety because of illness or substance abuse.

Dekle, Andrew A., MD – 0101-052295 Cairo, GA

11/03/04 Reinstatement denied; continued on indefinite suspension.

Desotell, Mary Jane, RCP – 0117-002500 Madison Heights, VA

11/02/04 License subject to terms for substance abuse rendering her unfit for the performance of her professional obligations and duties.

Do, Kevin Tien, MD – 0101-055102 Beverly Hills, CA

09/17/04 Mandatory suspension based on felony convictions of health care fraud and aiding & abetting; U.S. District Court, Eastern Division, California.

Doerwaldt, Harmut A., MD – 0101-046028 Winchester, VA

11/03/04 Reprimand based on failure to maintain complete & accurate inventory of controlled substances.

Dovberg, Jerome L., DPM – 0103-000339 Dumfries, VA


Duncan, Loretta L., MD – 0101-044141 Arlington, VA


Fant, Palmer W., MD – 0101-018442 Independence, VA

10/04/04 Surrendered privilege to renew license in lieu of further administrative proceedings regarding failure to provide required Practitioner Profile information to the Board.

Fenton, Leslie Howard, MD – 0101-016877 Washington, DC

11/10/04 Reprimand & monetary penalty of $2000 imposed based on restriction of license by the Maryland Board of Physician Quality Assurance.

Feola, David J., DC – 0104-001017 12/02/04 Reinstated; license restored as full and unrestricted.


McLean, VA Fischkelta, Joseph W., PA – 0110-840657 Springfield, OH

10/22/04 Reinstatement granted; license issued as full and unrestricted.

Fram, S. Marshall, MD – 0101-046129 Hollywood, FL

08/16/04 Voluntary surrender of privilege to renew license in lieu of further administrative proceedings regarding failure to provide required Practitioner Profile information to the Board.

Franklin, III, James, RCP – 0117-001866 Upper Marlboro, MD

10/12/04 Reinstated; license restored to full and unrestricted after 90 day suspension.

Freda, Gregory L., DPM – 0103-000888 Virginia Beach, VA

11/19/04 Continued on indefinite suspension.

Garada, Hazam, MD – 0101-053186 Fairfax Station, VA

08/12/04 Mandatory suspension based on felony conviction of health care fraud.

Garrett, Meredith G., MD – 0101-056750 Washington, DC


Garrett, William A., MD – 0101-055284 Washington, DC

09/20/04 Reprimand based on patient care issues involving three surgical patients and willful failure to provide information requested by an investigator of the Board. License expired 8/04.

Geissel, Georgia S., OT – 0119-001716 Richmond, VA

11/19/04 Summary suspension; continued practice is a substantial danger to the public health and safety.

Gomez, Carlos F., MD – 0101-050438 Charlottesville, VA

08/27/04 Indefinite probation based upon relapse of chemical dependency rendering him unable to practice medicine with reasonable skill and safety; required to comply with terms of HPIP contract.

Grogan, Patricia Jo, MD – 0101-047843 Reno, NV

10/28/04 Violation based on restriction of license by the North Carolina Medical Board; Hawaii Board of Medical Examiners; New Hampshire Board of Medicine; California Board of Medicine; and the Arizona Board f Medicine; no sanction imposed based discipline actions by the above-stated Boards.

Hedberg, Victoria R., MD – 0101-042619 Burgess, VA

09/17/04 Reprimand and compliance with HPIP based on impairment.

Henry, Camille May, MD – 0101-218852 Colonial Heights, VA


Herzog, John P., MD – 0101-057045 Richmond, VA

09/10/04

10/01/04

Summary suspension; continued practice is a substantial danger to public health and safety. Permanent surrender of license; unable to practice with reasonable skill & safety because of illness or substance abuse.

Hill, Augustus H., MD – 0101-052319 Silver Spring, MD

10/18/04 Reprimand with terms based on restriction of license by the Maryland State Board of Physicians.

Ho, Rosa Chau, MD – 0101-023571 Kettering, OH

09/27/04 Reprimand & monetary penalty of $2000 imposed for failure to provide Practitioner Profile information to the Board.

Hough, Rodney Kent, MD – 0101-020583 Carlisle, PA

11/07/04 Mandatory suspension based on a felony conviction of theft by deception in Pennsylvania.

Hsiao, Tony Yu-Lea, MD – 0101-051072 Annandale, VA

08/30/04 Reprimand based on re-labeling and dispensing medications and inadequate record documentation.

Hunt, Carl V., DO – 0102-036979 Manassas, VA

09/03/04 Reprimand based on pre-signing prescription blanks.

Ilupeju, Oluremi, MD – 0101-041294 Laurel, MD

09/27/04 Reprimand & monetary penalty of $1000 imposed for failure to provide Practitioner Profile information to the Board.

Johnson, Russell A., MD – 0101-045410 09/08/04 Mandatory suspension based on a felony conviction of


Colonial Heights, VA

10/01/04

internet prescribing. Reinstated; license issued as full & unrestricted; monetary penalty of $5000 imposed for unprofessional conduct & failure to provide Practitioner Profile information to the Board.

Kendall, Mark A., MD – 0101-027034 Williamsburg, VA

08/18/04 Reprimand and monetary penalty of $1500 imposed for failure to provide Practitioner Profile information to the Board.

Klein, David S., MD – 0101-035186 Heathrow, FL

10/22/04 Reinstatement granted; license returned to inactive status with terms.

Klepach, Garron L., MD – 0101-037875 West Bloomfield, MI


Kulawy, Steven, DC – 0104-000209 Rockville, MD

10/20/04 Indefinite probation terminated; matter continued subject to terms.

Louka, Kamal S., MD – 0101-036392 Virginia Beach, VA

09/20/04 Compliance with Board’s order of 11/21/03; license restored as full and unrestricted.

McLeod, James W., MD – 0101-030569 Roanoke, VA

09/30/04 Reprimand and ordered to comply with HPIP contract based on alcohol dependency relapse.

Marshall, John T., MD – 0101-037608 Chicago, IL


Masslofsky, Anthony P., PA – 0110-840793 Semora, NC

10/18/04 Ordered to complete contracts with North Carolina Physicians Health Program (NCPHP) & HPIP.

Mettetal, Jr., Ray W., MD – 0101-047877 Johnson City, TN

08/10/04

09/02/04

Suspension based on suspension of license by the State of Tennessee Department of Health. Reinstatement; license issued on indefinite probation.

Moseley, Charles D., MD – 0101-019922 Charlottesville, VA


Munnell, Dean Thomas, MD – 0101-234610 Aurora, CO


Nappi, Anthony, MD – 0101-049602 Hartford, NY

08/02/04 Reprimand based upon stayed suspension of medical license by the New York State Board for Professional Medical Conduct.

Noland, Daniel K., MD – 0101-102501 Newport News, VA


Ostman, Daniel Lee, MD – 0101-230805 Suffolk, VA

10/12/04 Reprimand with terms and monetary penalty of $2500 based on inappropriate prescribing of weight loss drugs and sale or dispensing of drugs without a license from the Board of Pharmacy.

Pannell, Wayne E., MD – 0101-044399 Radford, VA


Pholeric, John F., MD – 0101-026520 Reston, VA

09/20/04 Indefinite probation based on impairment; required to comply with HPIP contract.

Robinson, Audrey K., MD – 0101-840537 Washington, DC


Ruona, Luanne, MD – 0101-022727 Alexandria, VA

10/15/04 Voluntary surrender of license, after summary suspension, for not less than 18 months based on violation of Board’s Order of 5/19/04, substance abuse rendering her unfit for performance of duties and restriction of license in another jurisdiction.

Rupp, Corliss A., MD – 0101-228926 08/18/04 Monetary penalty of $1500 imposed for failure to provide


Atlanta, GA Practitioner Profile information to the Board. Saunders, Joyce H., MD – 0101-014086 Richmond, VA

11/12/04 Violation for failure to comply with Board’s Order of 6/1/01; license expired 7/31/04, probation continued if license is renewed.

Sidhu, Chandanjeet, MD – 0101-227873 Fairfax, VA


Smith, Jamiere Y., MD – 0101-045908 Chicago, IL


Suaray, Khalil M., MD – 0101-051689 Silver Spring, MD


Suh, Pyung Jay, MD – 0101-053141 Kingsport, TN

09/17/04 Monetary penalty $1500 imposed for failure to provide Practitioner Profile information to the Board.

Turak, Maryann, MD – 0101-024205 McLean, VA

10/15/04 Permanent surrender of license based on violation of inadequate medical records, failure to maintain professional boundaries with a patient, and health limitations.

Tynes, II, William V., MD – 0101-016018 Norfolk, VA


Waldrop, Preston A., MD – 0101-046000 Salem, VA


Walsh, Robert S., MD – 0101-036469 Pikesville, KY

08/13/04 Reprimand based on restriction of license by the Kentucky Board of Medical Licensure.

Weinstein, Jonathan I., MD – 0101-054813 La Grangeville, NY

10/22/04 Reinstatement granted; license issued to full and unrestricted license.

Winn, Herbert R., MD – 0101-020968 New York, NY


Wysor, Michael S., MD – 0101-228339 Kingsport, TN

12/09/04 Reprimand based on aiding & abetting of unlicensed practice, pre-signing prescription blanks and patient care issues. Has not practiced in Virginia since 8/02.

Zaman, Imtiaz, MD – 0101-048628 Chesapeake, VA


The following individuals were issued a license and a reprimand, based upon practicing without a license: Bernardo, Rene R., RT – 0120-004207 – Fairfax, VA 12/01/04 Brockman, Emily L., RT – 0120-004215 – Luray, VA 12/20/04 Burrell, John T., AT – 0126-000753 – Ashburn, VA 07/08/04 Carter, Lea A., RT – 0120-004221 – Gloucester, VA 12/22/04 Clark, Tammy V., AT – 0126-000820 – Fredericksburg, VA 10/04/04 Crews, Sarah D., RT – 0120-004151 – Nathalie, VA 09/30/04 Crockett, Frances M., RTL – 0122-001853 – Dublin, VA 09/30/04 Daniel, Melissa D., RT – 0120-000572 - Norfolk, VA 12/27/04 Evick, Julie A., RT – 0120-004211 - Franklin, VA 12/09/04 Galliher, Vicki D., AT – 0126-000793 - Fairfax, VA 08/23/04 Goldstone, Christina Jo, RT – 0120-003993 - Gloucester, VA 04/04/04 Hamm, Dorothy Joan, RTL – 0122-001818 - Fairfax, VA 04/08/04 Hudson, Jr., James R., RT – 0120-004199 - South Boston, VA 11/23/04 Ingram, Karen T., RT – 0120-004233 - Manassas, VA 12/27/04 Lester, Jennifer S., AT – 0126-000846 - Virginia Beach, VA 11/30/04 Linder, Aaron A., AT – 0126-000847 - Virginia Beach, VA 12/06/04 Miller, Valerie D., AT – 0126-000851 - Madison, VA 12/13/04 Mishra, Niraja, RT – 0120-004220 - Centreville, VA 12/21/04


Mueller, Monica M., AT – 0126-000841 - Portsmouth, VA 11/23/04 Noakes, Alison Faith, RT – 0120-004030 - Bedford, VA 05/27/04 Orange, Tammy A., RTL – 0122-001864 - Blue Ridge, VA 10/21/04 Phipps, Laura L., RT – 0120-004170 - Kingsport, TN 10/18/04 Preddy, Lisa, RT – 0120-001724 - Culpepper, VA 09/30/04 Rash, Tammy, RTL – 0122-001855 - Wytheville, VA 09/30/04 Sillin, Elizabeth S., AT – 0126-000816 - Norfolk, VA 10/04/04 Spencer, Brenda Y., RTL – 0122-001854 - Max Meadows, VA 09/30/04 Wampler, Brenda M., RTL – 0122-001856 - Marion, VA 09/30/04 Weeks, Tina, RCP – 0117-002655 - Hurt, VA 10/08/04

The following individuals were suspended due to submitting a check, money draft, or similar instrument for payment of a fee required by statute or regulation which is not honored by the bank or financial institution named thereon funds: Bean, Michelle, OT – 0119-002161 - Cleveland, OH 11/22/04 Peregrino, Olufemi, RCP - 0117-002459 - Roanoke, VA 12/23/04

January 1, 2005 to September 30, 2005, unless otherwise noted.

NAME AND LICENSE NO. DATE OF

ACTION ACTION

Aaron, Maureen M., MD – 0101-036310 Martinsville, VA

03/21/05 Indefinite probation terminated; restored to full & unrestricted license.

Allen, James Floyd, MD – 0101-036337 Newport News, VA

09/16/05 Stayed suspension and indefinite probation with terms based on alcohol dependence and misdemeanor convictions.

Ashmore, Jr., Robert E., MD – 0101-028239 Tallahassee, FL

03/23/05 Mandatory suspension based on voluntary surrender of license to the Georgia Composite State Board of Medical Examiners; said surrender having the same effect as a revocation of license.

Aubin, Russell John, DO – 0101-050036 Jamestown, RI

04/12/05 Mandatory suspension based on summary suspension of license by the Rhode Island Board of Medical Licensure & Discipline.

Bajwa, Manjit R., MD – 0101-023754 Alexandria, VA

01/06/05

06/03/05

Reprimand with terms based on inadequate patient communication, patient care issues, and inadequate treatment documentation. Compliance obtained with Board’s Order of 1/6/05.

Barry, Michael J., DO – 0102-201496 Chesapeake, VA

02/28/05 Reprimand & a monetary penalty of $1000 imposed for failure to provide required Practitioner Profile information to the Board.

Bertleson, Douglas E., MD – 0101-051708 Pasadena, CA

04/27/05 Mandatory suspension based on revocation of license by the Medical Board of California.

Bradley, Russell L., MD – 0101-057834 Hartwell, GA

04/19/05 Mandatory suspension based on revocation of license by Missouri State Board of Registration for the Healing Arts.

Braggs, Nadine P., PA – 0110-840247 Virginia Beach, VA

03/25/05 Reinstatement granted; license issued on indefinite probation with terms.

Brubaker, Alta Lois, MD – 0101-045362 Keezletown, VA

06/29/05 Reprimand based on self-prescribing Schedule VI controlled substances for personal use and placed on


probation for inadequate patient treatment documentation and failure to promptly provide medical records as per the Dept. of Health Professions’ request.

Burke, David Fowler, MD – 0101-048032 Norcross, Georgia

07/20/05 Revocation of privilege to renew license based on substance abuse rendering him unfit for performance of duties and unsuccessful completion of treatment for same.

Choragudi, Nagaraju L., MD – 0101-230815 Yonkers, NY

06/10/05 Reprimand based on censure and reprimand by the State of New York Office of Professional Medical Conduct.

Christian, Nathan H., DO – 0102-033534 Lynchburg, VA

06/05/05 Compliance obtained with Board’s Order of 11/3/03.

Clark, Carl Victor, MD – 0101-033685 Roanoke, VA

06/08/05 Mandatory suspension based on indefinite suspension of license by the North Carolina Medical Board.

Cooper, Thomas P., MD – 0101-027324 San Diego, CA

02/07/05

Monetary penalty of $1000 imposed for failure to provide required Practitioner Profile information to the Board.

Crowe, David Barr, MD – 0101-041053 Washington, DC

02/01/05 Monetary penalty of $2500 imposed for failure to provide required Practitioner Profile information to the Board.

D’Alessio, Richard B., MD – 0101-233414 Washington, D.C.

04/19/05 Mandatory suspension based on revocation of license by the Missouri State Board of Registration for the Healing Arts.

Dugan, Eric S., MD – 0101-238140 Pineville, LA

04/28/05 License granted based on compliance obtained with Board’s Order of 2/25/05.

Fagan, Martha E., MD – 0101-233798 FPO AP

04/28/05 Reprimand & monetary penalty of $1500 imposed for failure to provide required Practitioner Profile information to the Board.

Fannin, Jr., Raymond L., RCP – 0117-003806 Lottsburg, VA

03/22/05 Reinstatement denied and license revoked based on felony convictions of obtaining drugs by fraud and substance abuse.

Francisco, Alice N., MD – 0101-222560 Ridgefield Park, NJ

03/25/05 Reinstatement granted; license issued on terms; issued a reprimand and a monetary penalty of $2500.

Freedman, Bruce M., MD – 0101-043977 McLean, VA

07/26/05 Reprimand with terms based on authorizing & allowing nurses to exceed the scope and practice of their licensure thru issuance of prescriptions, assessments & treatments.

Garrett, Herman Alpha, MD – 0101-045559 Alexandria, VA


George, Francis H.G., MD – 0101-034572 Luray, VA

03/17/05 Indefinite suspension for at least one year based on failure to comply with the Board’s 11/2/03 order. Dr. George has appealed the Order to the Circuit Court of Page County.

Gervin, Alfred S., MD – 0101-036192 Richmond, VA

04/18/05 Violation for prescribing outside of a bona-fide physician/patient relationship in one case; no sanction imposed based on the dismissal of remaining allegations by the Special Conference Committee.

Golarz, Scott R., MD – 0101-233976 Bethesda, MD

04/28/05 Violation for failure to provide required Practitioner Profile information to the Board; no sanction due to corrective action.


Goldstein, Alben G., MD 0101-028331 Charlottesville, VA

9/19/05

Indefinite probation with terms based on multiple instances of prescribing opioids without patient monitoring, follow up treatment or review, and inadequate documentation.

Gonzalez, Ramon L., MD – 0101-036843 Burke, VA

03/17/05 Reinstatement of license from suspension denied and license revoked based on suspension & revocation of license by Maryland State Board of Physician Quality Assurance and District of Columbia Board of Medicine.

Goring, Kim Lesley, MD – 0101-235803 Bowie, MD

09/20/05

Reprimand based on failure to provide Practitioner Profile information to the Board.

Griffith, Wayman T., MD – 0101-054548 Mitchellville, MD

09/23/05

Monetary penalty of $1500 based on failure to update and provide Practitioner Profile information to the Board.

Gullattee, Alyce M., MD – 0101-020359 Washington, DC


Haase, Gregory A., MD - 0101-025209 Virginia Beach, VA

07/26/05 Monetary penalty of $1000 based on failure to provide required Practitioner Profile information to the Board.

Habib, Mahsin, MD – 0101-230371 Ashburn, VA

06/16/05 Indefinite probation with terms based on incomplete medical recordkeeping and inappropriate care and treatment of one patient.

Harper, Stephanie L., MD – 0101-224716 Washington, DC


Heatwole, Katherine, MD - 0101-046383 Norfolk, VA

03/18/05 Violation based on prescribing controlled substances outside of a bona fide practitioner patient relationship; disposition continued with terms.

Hetzel, Robert L., MD – 0101-232586 Leesburg, VA

09/23/05

Violation based on failure to update and provide Practitioner Profile information to the Board; no sanction imposed due to mitigating circumstances.

Hunt, Carl V., DO – 0102-036979 Manassas, VA


Hurwitz, William E., MD – 0101-028900 McLean, VA

06/02/05 Mandatory suspension based on felony convictions of conspiracy to traffic in controlled substance; drug trafficking resulting in death; drug trafficking resulting in serious bodily injury; and drug trafficking distributions; U.S. District Court, Alexandria Division.

Jacquelin, Michael Scott, RCP – 0117-000222 South Hill, VA

06/10/05 Mandatory suspension based on felony convictions of aggravated sexual battery and indecent liberties; Mecklenburg County, VA.

Janati, Abdorasool, MD – 0101-044684 Woodbridge, VA

03/21/05 Mandatory suspension based on felony convictions of conspiracy to commit health care fraud and health care fraud; U.S. District Court, Alexandria Division.

Johnson, Russell A., MD – 0101-045410 Colonial Heights, VA

09/28/05 Compliance obtained with Board’s order of 10/1/04.

Jordan, Robin, MD - 0101-035548 Arlington, VA

06/20/05 Reprimand with terms based on inability to practice medicine with reasonable skill and safety due to impairment.

Joynes, Michael H., MD – 0101-027026 Hampton, VA

04/13/05 License subject to terms based on patient care issues in one patient case.


Kandahari, Massoom M., MD – 0101-040044 Woodbridge, VA

05/17/05 Reprimand based on failure to provide safe & sterile area for chemotherapy medication preparation and administration of chemotherapy treatments by unlicensed individuals.

Kaniefski, Walter J., MD – 0101-055974 Gordonsville, VA

03/02/05


Kaplan, Adam Jared, MD – 0101-226697 Parkersburg, West VA

07/19/05 Reprimand and monetary penalty of $1000 for failure to provide required Practitioner Profile information to the Board.

Kelly, Peter F., DPM - 0103-000746 Roanoke, VA

02/03/05 Probation with terms & monetary penalty of $2000 imposed based on improper record keeping and storage & disposal of controlled substances.

Khawaja, Wasim Q., MD – 0101-235781 Lombard, IL

09/23/05


Kilgore, William T., MD – 0101-035671 Wytheville, VA


Kim, Mi Yong, MD – 0101-023297 Fairfax, VA

04/05/05 License subject to terms based on patient care issues in one patient case.

King, John A., DO – 0102-201296 Chantilly, VA

07/13/05 Mandatory suspension based on summary suspension by Michigan Board of Osteopathic Medicine & Surgery.

King-Jones, Patricia Y., MD – 0101-047522 Chesapeake, VA


Kohan, James M., MD - 0101-236925 Wind Gap, PA

07/21/05 Mandatory suspension based on indefinite suspension of medical license by the New York State Board for Professional Medical Conduct.

Kronen, Michael R., MD – 0101-051940 Silver Spring, MD

05/19/05 Indefinite probation terminated; restored to full and unrestricted license.

Lacey, Jami Ritch, MD – 0101-102593 Greensboro, NC

03/29/05 Mandatory suspension based on suspension of license by Georgia Composite State Board of Medical Examiners.

Lange, Paul A., MD – 0101-023310 Rehoboth Beach, DE

07/19/05 Voluntary surrender of privilege to renew license based on non-compliance with the Board’s Order of 05/30/02.

Lee, Alexander S., MD – 0101-225844 Victorsville, CA

05/04/05 Reprimand based on attempt to obtain a Schedule II drug under false pretenses.

Lewis, Verna Mae, MD – 0101-042565 Daleville, VA

04/04/05 Stayed suspension imposed by Board’s 1/4/04 Order continued on terms; reprimand and monetary penalty of $2500 based on falsification of document submitted to the Board.

Ligeti, Marianne B., MD – 0101-028676 McLean, VA

09/23/05 Monetary penalty of $2500 based on failure to update and provide Practitioner Profile information to the Board.

Loxley, Sidney S., MD – 0101-025877 Chesapeake, VA

05/20/05 Surrender of license pending matters before U.S. District Court.

Lucas, Michelle, RCP – 0117-003066 Kingsport, TN

04/22/05 Stayed suspension with terms based on felony convictions of attempting to obtain controlled substances by fraud and obtaining a controlled substance by fraud; Sullivan County Criminal Court, Tennessee.


Malakoff, Gary L., MD – 0101-036942 Washington, DC

05/11/05 Mandatory suspension based on summary suspension of license by District of Columbia Board of Medicine.

Marshall, Allan R., DC – 0104-000173 Manassas, VA

01/04/05 Surrender for suspension of the privilege to renew license based on non-compliance with Board’s Order of 10/24/01 and inability to safely practice.

Marshall, Harry Phillip, MD – 0101-246228 Washington, DC


Masslofsky, Anthony P., PA – 0110-840793 Semora, NC


Matthews, Richard E., MD – 0101-022661 Norfolk, VA

02/18/05 Mandatory suspension based on a felony conviction of driving under the influence, 3rd or subsequent offense; Norfolk, Virginia Circuit Court.

Matthews, Robert G., MD – 0101-024025 Annandale, VA


Mauroner, Jr., Norman, MD –0101-033227 Warrenton, VA

01/06/05 License subject to terms based on improper prescribing and improper documentation of treatment and patient care in multiple cases.

Mufti, Salman S., MD – 0101-236640 Fairfax, VA


Niechniedowicz, Frank, MD – 0101-230529 Dunn Loring, VA

02/18/05 Mandatory suspension based on suspension of license to practice medicine by District of Columbia Board of Medicine

Osborne, II, Tommy T., MD – 0101-050384 Cape Charles, VA


Pandit, Prabha B., MD – 0101-059307 Seminole, FL


Patel, Dinkar N., MD – 0101-034343 Grundy, VA

03/31/05 Compliance obtained with Board’s Order of 8/8/02; restored to full & unrestricted license.

Pevsner, Paul H., MD – 0101-026518 New York, NY

07/13/05 Mandatory suspension based on suspension of medical license by the New Jersey Board of Medical Examiners.

Plemmons, John K., MD – 0101-235267 Virginia Beach, VA

9/23/05


Pleskonko, Terry M., DC – 0104-000537 Staunton, VA


Pollock, Michael D., DC – 0104-000305 Richmond, VA

01/07/05 Terms and conditions against license terminated; license restored to full and unrestricted.

Posley, Keith A., M.D. – 0101-236584 Washington, DC


Prager, Mark William, DO -0102-037012 Wilmington, NC

07/20/05 Reinstatement granted; license issued on indefinite probation with terms.

Profera, Benedict A., DPM – 0103-000566 Lawton, Oklahoma


Ramsey, Jr., Roscoe W., MD – 0101-032672 Lanexa, VA



Ranieri, Thomas A., MD – 0101-227971 State College, PA


Reach, Ralph T., MD – 0101-041174 Lexington, VA

04/25/05 License to remain surrendered; upon successful completion of SPEX and remittance of fees, license will be reinstated on indefinite probation.

Rebeck, Kevin F. R., PA – 0110-840540 Virginia Beach, VA

05/26/05 Found in violation based on issuance of a prescription for a patient not authorized under his practice protocol; no sanction imposed based on findings of the Special Conference Committee.

Reid, David W., MD- 0101-033089 Virginia Beach, VA


Reilly, Michele Q., DO – 0102-037069 Ashburn, VA


Ringel, Steven D., MD – 0101-235850 Shawnee Mission, KS

05/25/05 Mandatory suspension based on voluntary surrender of license to the Board of the Healing Arts of the State of Kansas; said surrender having the same effect as a revocation of license.

Roscoe, Karen P., RCP – 0117-000868 Arlington, VA


Rothfuss, Henry L., MD – 0101-033520 Hampton, VA

02/23/05 License subject to terms & monetary penalty of $1000 based on inappropriate contact with a coworker.

Rudnick, Emily Frances, MD – 0101-235087 Richmond, VA


Sacks, Henry G., MD – 0101-234854 Fredericksburg, VA

04/18/05 License subject to terms based on improper diagnosis and care of one patient.

Shah, Deepa M., MD – 0101-234854 Alexandria, VA


Shegog, James H., MD – 0101-035008 Newport News, VA

03/16/05

05/11/05

Summary suspension based on determination that continued practice constitutes a substantial danger to public health and safety. License to remain suspended based on inappropriate prescribing of controlled substances to multiple patients; may not petition for reinstatement till 9/1/06

Shepard, Robert C., MD – 0101-224136 Cary, NC

04/27/05

07/20/05

Mandatory suspension based on revocation of license by the state of Massachusetts Board of Registration in Medicine. Reinstatement granted; license issued on terms.

Smith, Jr., Harold E., MD – 0101-220755 Mount Dora, FL

04/22/05 Mandatory suspension based on suspension of license by state of Tennessee Board of Medical Examiners.

Smith, Richard Keith, DO – 0102-037089 Xenia, OH

02/08/05 Found in violation based on failure to provide required Practitioner Profile information to the Board; no sanction imposed due to corrective action.

Statkus, Joseph K., MD – 0101-042648 Chantilly, VA

07/10/05 Suspension of at least one year based on failure to appropriately monitor treatment and administer prescriptions of opioids to multiple patients.

Stowell, Jeremy Averill, MD – 0101-010948 Virginia Beach, VA

08/02/05 Surrender of license for suspension with terms based on multiple instances of inappropriate prescribing of


Schedule II controlled substances and irregular documentation of patient prescription medication.

Streicker, William F., MD – 0101-025398 Charlottesville, VA

01/31/05


Sultan, Shafi A., MD – 0101-032381 Pennington Gap, VA

03/17/05 Suspension of license for at least one year based on patient care issues involving failure to consult or refer to medical specialists on three patient cases and failure to obtain informed consent before surgery in one patient case.

Tompkins, Dorothy G., MD – 0101-018071 Charlottesville, VA

04/26/05 Reprimand & monetary penalty of $4000 imposed based on unlicensed dispensing of methadone, inaccurate assessment & documentation of treatment, and inadequate documentation & recordkeeping of dispensing controlled substances.

Trent, David F., MD – 0101-039052 Richmond, VA


Updyke, Darin M., PA – 0110-001109 Fredericksburg, VA

06/16/05 Reprimand based on fraudulently obtaining Schedule IV and VI controlled substances for his own use and that of a family member.

Vaughan, Robert S. RCP – 0117-001910 Richmond, VA

09/02/05 Summary suspension based on determination that continued practice constitutes substantial danger to public health and safety based on fraudulently obtaining narcotics and substance abuse.

Vishakantaiah, Nagaraja, MD – 0101-840596 Richlands, VA


Weinmann, Edward M., DC – 0104-001186 Potomac Falls, VA

08/04/05 Permanent surrender of privilege to renew license based on failure to comply with the Board’s Order of 5/27/03.

Wicks, Wanda Jo, MD – 0101-234407 Baltimore, MD


Williams, Raymond T., MD – 0101-231343 Potomac Falls, VA


Wolcott, William P., MD – 0101-050978 Norfolk, VA

09/19/05 Relinquishment of privilege to seek reinstatement for twenty months based on issues of impairment and failure to perform and document examinations regarding treatment for multiple patients.

Woodard, Dean H., MD – 0101-041539 Manassas, VA

04/04/05 Reinstatement granted; license issued on indefinite probation and terms.

Wright, Jr., William, MD – 0101-040114 Wilmington, DE

07/26/05 Found in violation for failure to provide required Practitioner Profile information to the Board; no sanction imposed due to mitigating circumstances.

Yaratha, Sridhar, MD – 0101-236397 Marion, VA

06/20/05 Mandatory suspension based on indefinite suspension of medical license by the Iowa Board of Medical Examiners.

Zedd, Arnold J., MD – 0101-027587 Alexandria, VA

04/12/05 Mandatory suspension based on revocation of license by Pennsylvania State Board of Medicine.

The following individuals were issued a license and a reprimand, based upon practicing without a license:


Alexander, Christel S., RT – 0120-004279 – Petersburg, VA 03/01/05 Adams, Kelle Ann, RT -0120-004460 - Virginia Beach, VA 08/30/05 Bagherzadeh, Shereen, AT- 0126-00876 – Fairfax, VA 03/14/05 Bauby, Heather Lynn Ann, AT – 0126-00880 – Ashland, VA 04/05/05 Beach, Melissa, AT – 0126-000889 – Strasburg, VA 05/19/05 Bevins, Amber N., RT – 0120-004258 – Nickelsville, VA 02/08/05 Brooks, Toby J., AT – 0126-000863 – Lynchburg, VA 01/31/05 Brooks, Vicky L., RT – 0120-004459 – Cumberland, VA 08/30/05 Casola, Christopher G., AT – 0126-000859 – Lynchburg, VA 01/18/05 Compton, Betty L., RCP – 0117-005148 – Grundy, VA 02/24/05 Cunningham, Donna S., RCP – 0117-005257 – Petersburg, VA 06/29/05 Darr, Barbara L., RT – 0120-0042 – Boyce, VA 01/26/05 Dingfelder, Joy W., AT – 0126-000939 – Virginia Beach, VA 08/26/05 Ferguson, Beverly C., RT – 0120-004316 – Richmond, VA 04/07/05 Grevious, Nicole E., AT 0126-000870 – Charlottesville, VA 02/28/05 Gupta, Aashee, OT – 0119-004119 – Manassas, VA 05/27/05 Hightower, Robert K., RCP – 0117-005127 – Bracey, VA 01/31/05 Holland, Katherine J., RT – 0120-004398 – Windsor, VA 06/29/05 Hupp, Jason C., AT – 0126-000857 – Virginia Beach, VA 01/06/05 Kahl, Elizabeth S., AT - Christiansburg, VA 01/04/05 Kelly, Andrew T., AT – 0126-000858 – Williamsburg, VA 01/13/05 Kirspel, Paula N., RT – 0120-004245 – Ashburn, VA 01/18/05 Kirtley, Michael B. AT – 0126-000886 – Virginia Beach, VA 05/11/05 Lee, James O., RT, - 0120-004307 – Charles Town, WV 03/30/05 Leutze, Theresa A., RT – 0120-004483 – Midlothian, VA 09/22/05 Mandler, Karen L., RCP – 0117-005159 – Virginia Beach, VA 03/22/05 McDonald, Amanda L., RT – 0120-004439 - Palmyra, VA 08/18/05 Miller, II, Kenneth E., AT – 0126-000908 – Clear Brook, VA 07/19/05 Murray, Tonya L. Boes, AT – 0126-00871 – Chesapeake, VA 02/28/05 O’Brien, Jennifer L., OT – 0119-004049 – Richmond, VA 02/16/05 Pecsek, Kendall Elisabeth, RT – 0120-004354 – Richmond, VA 04/26/05 Porter, Carlena N., RTL – 0122-01922 – Virginia Beach, VA 04/26/05 Powell, Peggy H., RT – 0120-004386 – Chesapeake, VA 06/22/05 Saunders, Kristi L., RT - 0120-004291 – Chatham, VA 03/11/05 Sherwood, Andrea R., AT – 0126-000882 – Forest, VA 04/26/05 Street, Sharon R., RT – 0120-004406 – Ashland, VA 07/14/05 Tienken, Robert W., RCP – 0117-001058 – Arlington, VA 03/15/05 Turner, Tiffany T., OT – 0119-004140 – Richmond, VA 06/29/05 Williams, Lilyan J., OT – 0119-000883 – Bowie, Maryland 08/30/05 Young, Larry Drew, RCP – 0117-005314 – Arlington, VA 08/29/05

In Memoriam J. Thomas Hulvey, MD Tom Hulvey, MD, of Abingdon, was appointed to the Board of Medicine by Governor Mark R. Warner for a four-year term beginning July 1, 2004. Dr. Hulvey filled the medicine and surgery position from the 9th Congressional District, and from his first days on the Board, was enthusiastic about the work of the Board. He brought to his Board service a vast amount of experience in orthopedics and hospital-based care. In his brief time on the Board, he had a positive impact as he had throughout his career in his work with the US Navy, Johnston Memorial Hospital, the University of Virginia and UVA School of Medicine, the Southwestern Virginia Medical Society, the Medical Society of Virginia, the Virginia Orthopedic Society, the American Academy of Orthopedic Surgeons, Virginia Children’s Specialty Services, and the Virginia Healthcare Foundation. He was greatly respected by his fellow Board members and staff, and his untimely passing saddened all.

Documents

Virginia Board of Medicine BOARD BRIEFS · Suzanne N. Everhart, DO Stephen E. Heretick, JD Valerie Hoffman, DC Brent Lambert, MD Juan M. Montero, MD Robert T. Mosby, MD Jane E. Piness,